The Management of Acute Respiratory Infections in Children: Practical Guidelines for Outpatient CareThe Management of Acute Respiratory Infections in Children: Practical Guidelines for Outpatient CareWorld Health Organization, 1995. ISBN: 92-4-154477-5

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Book ReviewsThe Management of Acute Respiratory Infections in Children: Practical Guidelines for Outpatient Care Husn FrayhaMD Husn Frayha Head, Section of Infectious Diseases, Department of Pediatrics, MBC 58, King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh 11211, Saudi Arabia Search for more papers by this author Published Online:24 Apr 2019https://doi.org/10.5144/0256-4947.1997.264aSectionsPDF ToolsAdd to favoritesDownload citationTrack citations ShareShare onFacebookTwitterLinked InRedditEmail AboutIntroductionAcute respiratory tract infections are frequent in children, and are associated with high morbidity and mortality, particularly in underdeveloped and developing countries. Children with acute respiratory infections account for a significant proportion of patients seen at primary health facilities. It is estimated that pneumonia is responsible for 25% of deaths in children under five years of age in developing countries.This WHO book is intended for health staff working in outpatient first-level health care facilities. It provides guidelines for initial assessment and management of children with acute respiratory infections, and identification of children whose condition is sufficiently serious to warrant referral to hospital. The aim is to improve the outcome of children with acute respiratory infections, particularly young infants who are at the highest risk of complications and death from pneumonia.The approach to case management is summarized in two fold-out charts. One deals with the “Management of the Child with Cough or Difficult Breathing,” and the other with the “Management of the Child with an Ear Problem or Sore Throat.” These charts are reasonably sized and suitable for posting on an office wall and/or carrying around in a folder. They serve as quick and practical references to the management of children presenting with acute respiratory problems.Each chapter ends with a list of the essential skills and knowledge required by health workers for the management of acute respiratory infections. The book uses simple and clear terminology that makes it easy to read. The instructions are easy to follow. Technical words are defined at the end of the book.The first chapter includes a description of how to select the appropriate case management chart for assessment, classification and treatment of acute respiratory infections. Chapters 2, 3 and 4 focus on the assessment of a child presenting with cough or breathing difficulty. They provide instructions on how to obtain the necessary information about the child's illness by asking the appropriate questions, and looking for physical signs and symptoms that would identify those with severe disease that require referral to a hospital for treatment. These chapters contain many well-designed illustrative diagrams and case examples that reinforce their educational objective. Chapter 5 describes treatment guidelines for children who do not require hospitalization. These include detailed instructions on the dosages and administration of a select number of antibiotics, home care instructions to prevent dehydration and malnutrition, monitoring of fever and use of antipyretics and bronchodilators whenever indicated. While many of the acute lower respiratory tract infections may be due to a viral etiology and thus may not require antibiotics, the lack of viral diagnostic testing and close follow-up, and the possibility of superimposed bacterial infections may justify the empirical use of antibiotics in many of these patients. Such practices, on the other hand, may contribute to the global problem of increasing bacterial resistance.Chapter 6 deals with the assessment, classification and management of a child presenting with an ear problem. The instructions for the management of chronic ear infection are particularly well designed.Chapter 7 describes the management of a child with sore throat. The criteria for use of antibiotics in these health facilities where cultures are not available are pertinent.The annexes complement the material described in the main chapters. Of particular usefulness are the recommendations for use of rapid-acting bronchodilators. The failure to mention erythromycin for treatment of pertussis (Annex 2) is a shortcoming.This book will be useful for its stated purpose, i.e., health workers in primary health care centers in underdeveloped and developing countries with limited health facilities. While the recommendation for widespread use of antibiotics in young children with pneumonia is largely understandable, this practice will undoubtedly contribute to the ever-increasing problem of bacterial resistance. The choice of antibiotics, particularly for treatment of lower respiratory infections, is influenced by cost considerations. The applicability of the antibiotic treatment guidelines to other health care settings is limited. Previous article Next article FiguresReferencesRelatedDetailsCited byKhoja D (2019) The Management of Acute Respiratory Infections: Saudi National Protocol for Diagnosis and Treatment, Annals of Saudi Medicine , 18:1, (86-86), Online publication date: 1-Jan-1998. Volume 17, Issue 2March 1997 Metrics History Published online24 April 2019 InformationCopyright © 1997, Annals of Saudi MedicinePDF download